A Little Change Makes a Big Difference Online Pledge Form

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I authorize the following amount to be deducted from my pay for "A Little Change Makes a Big Difference." I agree that the deductions will continue until I give my employer's payroll department written notice that I wish to discontinue the deductions. I understand that I may discontinue the deductions at any time.

Note: Payroll Deduction to begin with your next pay period.

MMG and Corporate employees are not eligible for payroll deduction.

(Typing your name here indicates that all of the above information is accurate and acts as your electronic signature.) *
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